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Medicare Eligibility: Who Qualifies for Medicare in the U.S?

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Here's an overview of Medicare eligibility:

Age-Based Eligibility

  • Most people become eligible for Medicare when they turn 65 years old.
  • Eligibility begins on the 1st day of the month of your 65th birthday.
  • You can apply for Medicare during the Initial Enrollment Period, which spans three months before your 65th birthday, your birthday month, and three months after. Here’s another information piece that may help CLICK HERE!

Disability-Based Eligibility:

  • If you are under 65 but have received Social Security Disability Insurance (SSDI) benefits for at least 24 months, you may qualify for Medicare.
  • You’ll automatically be enrolled in Medicare in the 25th month of receiving SSDI benefits.

End-Stage Renal Disease (ESRD) Eligibility:

  • Individuals of any age with ESRD, which is permanent kidney failure requiring dialysis or a kidney transplant, may be eligible for Medicare.
  • Eligibility may begin after a waiting period, usually three months.

Amyotrophic Lateral Sclerosis (ALS) Eligibility:

  • If you have been diagnosed with ALS, often known as Lou Gehrig’s disease, you are eligible for Medicare from the month your disability benefits begin, without a 24-month waiting period.

Income and Resources:

  • While age and specific medical conditions are primary factors, your income and resources may also affect your eligibility for certain Medicare programs, such as Medicaid and Medicare Savings Programs.

U.S. Citizenship or Legal Residency:

  • To be eligible for Medicare, you must be a U.S. citizen or a legal permanent resident (green card holder) who has lived in the U.S. for at least five continuous years.

Working Spouse or Dependents:

  • In some cases, spouses who have not worked or paid into Social Security may still be eligible for Medicare based on their spouse’s work history.

Enrollment Periods:

It’s essential to enroll in Medicare during the appropriate enrollment period to avoid late enrollment penalties.

Remember that Medicare can be a complex program, and eligibility can vary based on individual circumstances. It’s advisable to consult with the Social Security Administration or a Medicare specialist to determine your specific eligibility and make informed decisions about your healthcare coverage. Or yours truly, over at Bridged Insurance! For a general overview of Medicare CLICK HERE!

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